Suicide is universally a gender issue, with male deaths outnumbering female by a large percentage in virtually every country, in very age group and in every year since records began.

Research into suicide however has largely been gender-neutral, and is only now even beginning to show any curiosity about male gender experience of suicide. Many books on suicide don’t consider male gender at all as a theme, meaning that the male gender experience is usually invisible.

This vast disparity between the magnitude of male suicide and our lack of curiosity about the male lives behind the statistics is, in fact, the biggest clue to the causes of male suicide: the gender empathy gap. A lack of empathy for men and masculinity reflects the fact that human gender behaviour has an evolutionary basis.

An evolutionary basis

Sex differences are the basis for reproduction and evolution not just in the human species but in many others. In every culture, the evolved male archetype is about “strength”: to take risks, to provide, protect, fight, win and control emotions in order to focus on the successful performance of dangerous tasks. Because of the ‘male protector’ archetype we are all implicitly more tolerant of male death and suffering for the simple reason that we expect the male gender to offer protection rather than receive it. The statistics on deaths and protective behaviours across the world prove this. Even the survival figures from the Titanic, where most of the women survived and most of the men died, show men were trying to protect women and children by getting them into the life boats.

Male shame

Male suicide is linked quite clearly to shame about weakness and failure, but this shame mirrors a societal lack of empathy for the male experience – this is why men don’t value their own vulnerability or seek help because they don’t expect to receive help and this is actually reflected in a lack of services for male victims and resistance to seeing men as a group with needs of their own.

However the currently popular social constructionist narratives around gender assume male gender behaviour is a set of stereotypes that can simply be retaught and remoulded. Efforts are therefore being made – mistakenly – to educate boys and men to change their attitudes and behaviour. Masculinity itself is felt to be harmful and men are blamed for not seeking help and ultimately even for their own suicidality. Paradoxically this of course only reinforces the archetype that men are responsible for sorting all problems out, including themselves.

The shame men feel in seeking help is implicit in all society. Telling men to open up and seek help is a double standard when the actions and attitudes of society are not sympathetic and only reinforce the shame. This only confuses and paralyses men more.

Can we change men’s help-seeking behaviour?

In my chapter on male suicide I make it clear that trying to change an archetype as if it were a stereotype is not only mistaken but damaging and counterproductive. However, I argue that it is possible to redefine and reapply what the male archetype means in a modern social context:

We can redefine male strength to include help-seeking, because help-seeking involves facing problems, taking control and taking action. These are archetypally masculine attributes. If we tell men that by seeking help they are protecting their families, it plays into the archetype, not against it.

Helping any group can also only work if the approach is empathic, yet with men we have constantly tried to change or educate them, rather than accept them as they are or empathise with their world. This means we have not respected male differences in ways of communicating, relating and dealing with emotion. We have tried to fit men into a “counselling” model of what we think they should be, which is ironically closer to the female archetype.

The evidence is clear however that where services listen to men and offer help in a way that honours the male archetype, things work much better. This can be achieved through male spaces, doing things together, talking shoulder to shoulder rather than face to face.

Men do talk, if people listen in male-friendly ways. If we can change the language of our message on suicide from “open up, you stubborn men” to “let’s all open up to men” we will get a lot further and save many more lives.

About the author

Martin is a consultant clinical psychologist and psychotherapist, currently working with “Change, Grow, Live”. He is a lecturer, author, campaigner, and broadcaster. He worked in the NHS for 30 years, becoming head of psychological services in two mental health Trusts. He has advised government and has regularly broadcast with the BBC on mental health issues. He is co-founder of the Male Psychology Network, and was the original proponent of the Male Psychology Section of the BPS, of which he is the first Chair. He was branch consultant to the Central London Samaritans for over 10 years and has also been an adviser to the College of Medicine and the Royal Foundation.

Measures of mental health can be difficult to get right. For example, if you want to measure suicidality, the most obvious thing to do is ask people questions about how much they have been thinking about suicide, have they ever attempted suicide etc. This can make for an uncomfortable time for many participants, and can result in people dropping out of studies.

But what about if you can tap into mental health by asking people about their mental wellbeing? This would make the participant’s experience a lot less awkward, but can it be done in practice? Well, the Positive Mindset Index (PMI) (Barry, Folkard & Ayliffe, 2014), which asks people to rate their level of happiness, confidence etc, has proved to be strongly negatively correlated with suicidality (r = -.539) and strongly positively correlated with the SF-12 measure of mental health quality of life (r = .678). So not only does the PMI give you a sense of a person’s mental positivity, but it also gives you a sense of their mental health.

The PMI has proved it’s worth in several published projects since 2014, with a variety of demographics (people with health problems, men and women of various ages and ethnicities etc). But the PMI also has an advantage for people who interested in men’s mental health: it just so happens to be very male-friendly.

A male-friendly measure

What makes the PMI so male-friendly? Well, it is a very short questionnaire, and easy to fill in. Men are notorious in the research world for being difficult to recruit and having little time for research, so brief measures are definitely the way to go. It is also useful for people with limited reading skills, because it uses very few words, and all of them are relatively simple. It also also uses a neutral midpoint, which means participants aren’t under pressure to give strong opinions if they don’t want to. If participants become frustrated or bored, they can drop out of studies.

Because of this male-friendly aspect, the PMI has been used on several of the Male Psychology Network research projects with a total of almost 10,000 participants:

Men and women in the UK aged over 50 years old (N = 394) (Hadley, Newby & Barry, 2019, in press).

So what does the PMI look like?

The Positive Mindset Index scale consists of six items (happiness, confidence, being in control, emotional stability, motivation and optimism) on a 5-point Likert scale.

Participants are asked:

Please select one of the options (e.g. “happy” or “unhappy”) for the words in each row, indicating how you are feeling at this moment.

The response options are selected in each row:

Item 1

Very unhappy

Unhappy

Moderately happy

Happy

Very happy

Item 2

Very unconfident

Unconfident

Moderately confident

Confident

Very confident

Item 3

Very out of control

Out of control

Moderately in control

In control

Very in control

Item 4

Very unstable

Unstable

Moderately stable

Stable

Very stable

Item 5

Very unmotivated

Unmotivated

Moderately motivated

Motivated

Very motivated

Item 6

Very pessimistic

Pessimistic

Moderately optimistic

Optimistic

Very optimistic

The PMI is scored from 1 to 5, with lower scores indicating a less positive mindset. The mean of the 6 scores is used. The average score is around 3.5, with slight variation for age and culture. The scale shows excellent psychometric properties, and further details for researchers can be found here.

Is positive mindset related to positive psychology, or positive masculinity?

Although not specifically derived from positive psychology, there is some common ground between positive psychology and the PMI. Up until the 1990s, men and masculinity were seen in fairly benign terms in the field of psychology. However the 1990s saw a new deficit model of masculinity, which defined masculinity in negative terms (including misogyny and homophobia) and explored the ways in which masculinity might be damaging to the mental health of men, boys, and everyone around them. It’s been a relief to many people that the past decade has seen the birth of ‘positive masculinity‘. Positive masculinity has it’s roots in positive psychology, so brings not just the return of masculinity as a benign construct, but sees masculinity as something which is potentially an asset. In tandem with positive psychology / positive masculinity (PPPM), we have seen the development of the Male Gender Script (Seager, Sullivan & Barry, 2014), which takes a realistic view of masculinity, rather than the excessively harsh view of the 1990s.

Using the PMI in your research

The PMI is free to use and is very handy because it is short and therefore easy to add to a study without adding a burden to the person filling in your study. It is also very easy to score, so is attractive to researchers at all levels of experience. It’s not simply a measure for men’s mental health either, and although it hasn’t been standardised for children or non-English speakers, is perfect for use with adults in general.

For a more detailed description of the scale and it’s properties, see here.

Dr John A. Barry is a Chartered Psychologist and Associate Fellow of the British Psychological Society, Honorary Lecturer in Psychology at University College London, clinical hypnotherapist, and author of over 60 peer-reviewed publications on a variety of topics in psychology and medicine. John is a professional researcher and has taken an interest in improving the teaching of research methods and statistics. He has practiced clinical hypnosis for several years and is a member of the British Association of Clinical and Academic Hypnosis. His Ph.D. was awarded by City University London, on the topic of the Psychological Aspects of Polycystic Ovary Syndrome, which is also the topic of his forthcoming book (Palgrave Macmillan, 2019). He is co-founder of both the Male Psychology Network and the Male Psychology Section of the British Psychological Society (BPS), lead organiser of the Male Psychology Conference, and co-editor of the Palgrave Handbook of Male Psychology and Mental Health (2019).

Johnny Thunders, guitarist with the hugely influential New York Dolls and The Heartbreakers, is a rock & roll icon. His is a story of incredible talent tragically squandered to heroin addiction. This article speculates that the cause of this tragedy was dad deprivation.

His story is depressingly familiar, echoed in the lives of contemporaries of the music scene in the late 70s, such as Sid Vicious and Steve Jones of the Sex Pistols. Like Vicious and Jones, Thunders (real name John Anthony Genzale) had a dad-shaped hole in his life. Shortly after he was born into an Italian-American household in Queens, New York, Thunders’ womanising father left home, leaving him to be raised by his mother and older sister.

His sister’s record collection – mainly girl groups like the Shangri-Las – helped fill the void for a time, and we might speculate on how this influenced the cross-dressing of The New York Dolls. But Thunders was also a natural athlete and excelled at baseball. He even got a tryout with the Little League’s Philadelphia Phillies, but he wasn’t allowed to take part because of the requirement of the presence of a father.

But clearly Thunders had spirit and he transfered his energy into guitar playing and fashion. These activities however didn’t fill the dad-shaped void in his life, as suggested by his tendency to take drugs. He and The Dolls became notoriously unreliable due to the influence of drugs and addiction, and his music career was crippled because of the music industry’s lack of willingness to take a risk investing their money there.

Drug-taking wrecked his mental health too. Thunders was sometimes described as appearing depressed. One story tells of him fleeing a hotel room, terrified because he thought Darth Vader was hiding behind his curtains. Psychologists of a psychoanalytic nature might read something into the fact that the Darth Vader character was created as a ‘Dark Father’, which is perhaps what Thunders’ father became due to prolonged absence.

Like his father, Thunders was popular with women. He tried to settle down and had three sons with wife Julie Jordan in the late 70s, but his drug use made his life shambolic and incompatible with family life. In the early 1980s Jordan took the children from him, and he never saw them again. His eldest son Vito, would later be jailed by drug trafficking, perhaps also a victim of dad-deprivation.

There is a rumor that is interesting in regards to Thunders and Sid Vicious, both of whom were victims of dad-deprivation. It is claimed that Thunders introduced Sid Vicious to heroin, waving a syringe in his face and shouting: “Are you a boy or a man?” Perhaps this shows that in the absence of healthy rites-of-passage, men will create unhealthy rites-of-passage.

Thunders’ drug abuse made him hard work for anyone around him and contributed to his notoriety, but it would be naïve to think that it contributed to his talent. In fact his drug use vastly reduced his creativity and output, and who knows how many more great songs he would have recoded had he hadn’t been so addicted and self-destructive.

According to Thunders’ biographer, Nina Antonia: “The thing that was always missing was a father figure”. He could have been a massive success, but he became best known for failure. One of his best known songs is “Born to lose” – clearly that’s how he felt, and that’s how he lived. He died tragically aged 39 in New Orleans in seedy and mysterious – possibly murderous – circumstances. Definitely not the way any father wants their son’s life to end, and something for all fathers to learn from.

About the author

Dr John A. Barry is a Chartered Psychologist and Associate Fellow of the British Psychological Society, Honorary Lecturer in Psychology at University College London, clinical hypnotherapist, and author of over 60 peer-reviewed publications on a variety of topics in psychology and medicine. John is a professional researcher and has taken an interest in improving the teaching of research methods and statistics. He has practiced clinical hypnosis for several years and is a member of the British Association of Clinical and Academic Hypnosis. His Ph.D. was awarded by City University London, on the topic of the Psychological Aspects of Polycystic Ovary Syndrome, which is also the topic of his forthcoming book (Palgrave Macmillan, 2019). He is co-founder of both the Male Psychology Network and the Male Psychology Section of the British Psychological Society (BPS).

Around 85% of rough sleepers are men (St. Mungos, 2016). The reasons for homelessness are many and complex, but the most frequently cited reasons for male homelessness are relationship breakdown, substance misuse, or leaving an institution (e.g. prison, care or hospital) (Brown et al, 2019).

At any one time in the UK there are around 5000 rough sleepers (Ministry of Housing, Communities & Local Government, 2017). This isn’t counting the group often called the ‘hidden homeless’, a much larger number of people – at least 250,000 – with no stable accommodation (Shelter 2016). We know that almost half of rough sleepers have mental health needs (Combined Homelessness and Information Network, 2017), but these figures don’t identify the other type of ‘hidden homeless’ – people with autism.

Autism effects 1% of the population (Brugha et al, 2016). Autism exists on a spectrum of severity (Autistic Spectrum Disorder, or ASD). There are some interesting gender differences that might lead to underestimates of ASD in females (van Wijngaarden-Cremers, 2019), but most estimates suggest that more severe cases are four times more common in males, and the less severe form (Asperger Syndrome) is nine times more common in males (Barry & Owens, 2019).

Given the fact that most homeless people are male, we would expect a larger proportion of homeless people to have autism. In the first study on this topic published in a peer-reviewed journal, Churchard et al (2019) found that autism is at least 12 times more common in homeless people than the general population (or probably more, if it was possible to identify the ‘hardest to reach’ homeless people). This figure far exceeds the rate you would expect if autism in homeless people was simply due to both autism and homelessness being more common in men. So if gender doesn’t fully explain the over-representation of autism in the homeless population, then why are so many autistic people homeless?

Well, substance abuse does not explain it, because people with autism are less likely to have problems with substance abuse than other people (Butwicka et al, 2017). However Churchard et al (2019) suggest that the greater levels of social isolation experienced by people with autism might be the key; autistic people often have fewer people to turn to if things go wrong in their lives, such as their housing being threatened. People with autism are also less likely to be employed, so might slip into the poverty trap more easily (Calsyn & Winter, 2002). Churchard et al also suggest that because people with autism are more likely to experience sensory difficulties (e.g. finding noise distressing), this makes living in shared accommodation or a hostel virtually impossible. Also for those with cognitive impairments to abilities such as planning, everyday independent living might become virtually impossible.

Although the current level of knowledge regarding homelessness and autism is very basic, there has been some progress by a group called Homeless Link (2015), who have created practical guidelines on how to identify autism in homeless people, and how to communicate in a way that best facilitates support for the homeless person.

This article only scratches the surface of mental health issues in homelessness. Other issues that impact the general population of homeless people include a history of childhood abuse and neglect, seen in 80% of homeless people (Torchalla et al. 2012). This type of history creates special problems for housing homeless people, because they may have learned to associate home with abuse and neglect (Duffy & Hutchison, 2019). Trauma prior to homelessness is also common (e.g. military-related PTSD), as is trauma as a result of life on the street (Buhrich et al. 2000).

More research is needed to identify the scale of the problem of autism in homelessness, and to develop evidence-based methods of helping these vulnerable people. There can be little doubt that homeless autistic people should be one of the key issues for anyone interested in Male Psychology.

About the author

Dr John A. Barry is a Chartered Psychologist and Associate Fellow of the British Psychological Society, Honorary Lecturer in Psychology at University College London, clinical hypnotherapist, and author of over 60 peer-reviewed publications on a variety of topics in psychology and medicine. John is a professional researcher and has taken an interest in improving the teaching of research methods and statistics. He has practiced clinical hypnosis for several years and is a member of the British Association of Clinical and Academic Hypnosis. His Ph.D. was awarded by City University London, on the topic of the Psychological Aspects of Polycystic Ovary Syndrome, which is also the topic of his forthcoming book (Palgrave Macmillan, 2019). He is co-founder of both the Male Psychology Network and the Male Psychology Section of the British Psychological Society (BPS).

Kids are screaming. I’m completely skint and my body is achingly tired, but it’s all worth it. Why? Because I saved a life today.

5 years ago I lost a life. The life of my childhood best friend. Steve and I were like brothers. Born only 4 days apart, the decade from 11-21 were inseparable. There wasn’t one without the other. But all that changed when we got older, got families, moved away. And on the 28th of May 2014 – Steve took his own life. And I was crushed.

A man every 2 hours is taking their own life in the UK. But Steve wasn’t a statistic. He was a father, a son, a brother and friend.

For 20 years I’ve been an advertising creative. I sell things. And more recently I try to get people to think differently about things – call it behaviour change if you like. So after a chat with JC (one of the founders of Movember) who told me that men of my age watch documentaries and sport, I thought What if I created a problem-solving documentary? What if I combined my skills and experience and try to help solve this problem?

So in December 2017 I began a journey. A journey of self recovery but one also trying to help men help themselves. And stop them taking their own lives. I began with a crowdfunder (raising just over £20K in the end) to create a documentary to save men from suicide.

In the 18 months that followed, I travelled up and down the country, interviewed 35 people, got over 50 hours of footage, and in the end crafted a feature length documentary.

The goal was to save one life. And we did that on the night of the premiere. A friend told me that when I asked him to do a video diary of his mental health, it forced him to open up and get help. He had written the letters to his wife and kids. He had made plans to kill himself. But me asking him to talk about his mental health made him stop. Made him reconsider and made him open up.

And that’s been the amazing thing about this project. What I have learnt. I didn’t even know there was a Male Psychology Network. I didn’t know male psychology was different to female psychology. Off course it is. But I had never thought about it. And my interview with John Barry was enlightening. The way that men think. Why psychology is different. Why men might not go to therapy as much as women do.

It was one of the conversations, that got me thinking that this film had to be more than mental health awareness, it had to be mental health action.

So now, after a premiere in March and 24 screenings up and down the country, many at pubs – going to where the men are – I’ve created a very simple idea called Talk Club. Inspired by Andy’s Man Club and the CALM Best Man project – I thought What if we just help men talk to their mates?

What we do is simply ask men to score their feeling out of 10. You can’t have 7 – everyone says 7. Picking 6.9 or 7.1 is a decision, so that’s what we ask men to do, and then ask them to try to explain that number.

So that’s what we are doing. We show the film. Spark conversation and ask them to talk about their mental health, to take their mental fitness more seriously.

We also created a closed talking group on Facebook, which amazingly in 8 weeks has 715 members. And smaller, local face to face talking groups are popping up off that.

Through a culmination of nature and nurture, men are often portrayed to be “strong”, competitive and aggressive, whilst this has had certain advantages from an evolutionary perspective it also has a shadow side. Often with the men that I work with in prison exploring emotions and experiencing sadness are seen as “weak”, there is often difficulty in accessing these emotions, a limited ability to describe and label them, and individuals can often be disconnected and dissociated from how these feel within the body. Displaying vulnerability such as crying is often seen as a weakness, but as human beings these are natural ways to respond to the world where situations that bring on rejection, abandonment, humiliation and unfairness which are an inherent part of being human.

As a way to survive such overwhelming emotions they are often supressed by alcohol use, denial, minimisation, distraction, over- achievement to feel good, or emotions are bottled up and can lead to violence or suicide. Boys can often be ridiculed, shamed or punished for showing emotions such as fear, anger or sadness, and emotions are generally not accepted by many parts of society. Many men will often struggle to experience such emotions therefore having a safe space where they can talk about it can be difficult. Men may choose not to access talking therapy because talking about problems and emotions may not be seen as something that would be helpful (Holloway et al, 2018).

Yoga is an ancient philosophy that is being practiced across the world. Currently within the western world yoga is often seen and packaged through a fitness lens; in fact that’s how I first got started through the physical “asana” practice as a way to get fit and exercise my body, and then I found out that it’s a much deeper practice than merely moving the body and getting physically fitter. The way in which yoga is often perceived, especially for men, is that are they unable to get into the poses as they are not flexible in their bodies as women and not able to “do it”. This perception is often created by images of people in bendy poses, predominately women, who have different body frames and structure to men.

Within my practice I started to be more mindful about my connection to my body and that when moving initially I was forcing myself to go into a pose. I started to become conscious of when I wasn’t able to get into a pose, if there were others around me, I felt embarrassed I wasn’t able to get into the pose I recognised judgemental thoughts I had and tightening of my muscles which made it more difficult to move and restricted my breath. However I started to learn that when I had a more inquisitive and curious mentality and grounded myself in the breath, I had calmed my nervous system which allowed me to relax and go deeper into the pose. My body relaxed and I was less distracted by my judgements.

I have reflected on how as men we are often socialised to push harder, be self- critical and not feel good enough. Also there is often a limited space where vulnerability and insecurity can be explored, because there is a fear that showing it could lead to ridicule and humiliation, this all is an embodied experience that can be explored through yoga.

Yoga can be a tool in which men can start to undo these negative and harsh messages they have received, by gaining greater awareness about themselves in terms of body and mind patterns. The practice of yoga can develop awareness, proprioception and interoception, which are likely to help practitioners to understand and feel safe with emotions. Thus this might have an improved effect on mental health in men, as yoga becomes an accessible way to root yourself in the body and have an understanding of the self both on and then off the mat.

About the author

Dr Sunil Lad is a Counselling Psychologist working with men in prison with mental health difficulties, and a qualified yoga teacher. His chapter Of Compassion and Men: Using Compassion Focused Therapy in Working with Men appears in the new Palgrave Handbook of Male Psychology and Mental Health by Barry, J.A., Kingerlee, R., Seager, M., Sullivan, L. (Eds.). DOI 10.1007/978-3-030-04384-1

A cursory glance through recent news articles surrounding gender suggests women are struggling in modern society, and uniformly have it worse than men. Indeed, there are many contexts where women are disadvantaged, such as the pattern of fewer female world leaders, CEOs, and full professors. At the top of the societal distribution, men are overrepresented, which is certainly worthy of attention and concern. However, if one were to take a careful look at the bottom of the societal distribution, they might be surprised to see men are also overrepresented. For example, compared to women, men are more likely to be homeless, suffer from substance abuse, commit suicide, drop out of high school, never attend college, be imprisoned, and even die 5 years sooner on average.

Why is it that the social discrepancies whereby men are disproportionately afflicted receive significantly less attention? A reader might espouse the argument, “well these are issues under men’s control”. Perhaps that is true, to some degree. However, there are some cases where these discrepancies are at least partially the result of active biases. For example, legal research demonstrates that men receive longer prison sentences than do women, even when they commit identical crimes (Mazella & Feingold, 1994; Mustard, 2001). Why then, do we fail to recognize these cases where men are suffering?

Researchers in cognitive moral psychology have discovered that when people evaluate situations in which harm occurs, they instinctively cast the involved parties into one of two roles: intentional perpetrator and suffering victim (Gray & Wegner, 2009). That is, the human mind naturally perceives moral actions through a dyadic template, such that we assume those involved are either the harm-inflicting agent or the harm-experiencing patient. Moreover, once we cast a target as a perpetrator, it is incredibly difficult to subsequently view them as a victim, and vice versa.

In our research, we tested the hypothesis that the application of this cognitive template might be biased by gender (Reynolds, Howard, Sjastad, Okimoto, Baumeister, Aquino, & Kim, 2019) Specifically, we predicted that people more readily place men in the role of perpetrator and women in the role of suffering victim. If so, this tendency might suggest it is challenging for us to perceive men as victims and respond compassionately to their suffering.

To test this hypothesis, we had participants evaluate situations involving workplace harm, such as a surgeon bullying their surgical trainee. We manipulated whether we referred to the targets in the scenarios as either victim and perpetrator or more neutrally, “party A or B”. We asked participants to recall whether the harmed target was male or female, even though the scenario never mentioned this. Across the different scenarios, we found that people overwhelmingly assumed the harmed target was female, but especially when we labeled the targets as perpetrator/victim. This finding suggests we more easily place women in the victim role. Moreover, when participants assumed the harm target was female, they felt more warmly towards her and perceived her as more moral, compared to when they assumed the harmed target was male.

In another study, we had participants evaluate an ambiguous joke made in the workplace. This time, we manipulated the sex of both the employee making the off-colored joke and the recipient of the statement. Participants assumed a female employee who heard the joke experienced more pain than a male recipient of the identical statement.

Moreover, participants also shifted their perceptions of the employee making the joke. When a man made the joke, participants were more willing to punish him, less willing to forgive him, less willing to work with him, and less willing to nominate him for a leadership position, compared to a woman who made the same exact joke. These patterns suggest we not only more easily recognize harm to women, we also more strongly desire to punish men, a response typical to those placed in the perpetrator role.

We then wanted to explore whether this pattern holds for groups of men or women. We had participants evaluate a scenario where a managerial team needed to make the decision to fire a group of employees whose jobs were redundant. We manipulated whether those fired employees were male or female, but kept everything else identical. Participants assumed the fired female employees suffered more pain than the fired male employees, even though real world data suggests men who lose their job suffer worse outcomes (Wang, Lesage, Schmitz, Drapeau, 2008).

Moreover, participants also differentially judged the managerial team based on our manipulation. Managers who fired women were assumed to have inflicted more harm, to have made a more unfair decision, and to be less moral. This pattern suggests we not only more easily recognize female suffering, but also more harshly judge those who inflict suffering onto women than those who inflict suffering onto men.

Altogether, this body of findings indicates that our application of moral typecasting is biased by gender. We more readily place women in the victim role, which makes us more sensitized to their suffering. We also more readily place men into the perpetrator role, which makes us more inclined to punish and blame them.

This gender bias in moral typecasting has many important implications. It suggests that when we encounter men’s suffering, we will be less inclined to notice it, perceive it as unjust, or feel motivated to alleviate it.

Our findings may help explain the asymmetric discussion surrounding gender differences in social outcomes. It is cognitively easier for us to detect women’s suffering and respond with sympathy and aid. However, when we learn these statistics about the negative outcomes suffered by men, we are less inclined to view men as victims, and might instead, either overlook the suffering or just blame it on men themselves.

Tania Reynolds received her PhD in Social Psychology from Florida State University under Dr. Roy Baumeister and Dr. Jon Maner. Her research examines how pressure to compete for social and romantic partners asymmetrically affects the competitive behaviors and well-being of men and women.

Through a joint appointment with the Gender Studies department, Reynolds offers courses on human sexuality and sex/gender differences. As a collaborative research team with Justin Garcia and Amanda Gesselman, Reynolds hopes to examine the dispositional predictors and physiological correlates of individuals’ romantic relationship experiences, as well as how these associations may differ across gender and sexual orientation.

Men are twice as likely to experience a traumatic brain injury (TBI) as women. This suggests that aspects of masculinity, such as choosing risky jobs and sports, play an important role in how people acquire their brain injury. Research also suggests that masculine identity has an impact on how people manage the experience of illness. Adjustment to traumatic brain injury can involve changes in cognitive, behavioural, emotional and physical functioning. Given the potential disruptive consequences of TBI, the day-to-day lived experience of being in the world can be, and often is, altered for the individual.

Our chapter in the Palgrave Handbook of Male Psychology and Mental Health summarises research which explores masculine identity in relation to how men experience these adjustments. Individuals who have had a TBI can experience a changed sense of personal identity (Levack, Kayes, & Fadyl, 2010) and changes to the self tend to be viewed negatively in comparison to the pre-injury self (Carrol & Coetzer, 2011). Identity as a man can be threatened by the changes in interactions and activity which can lead to a loss of traditional male roles such as being a provider, being strong, protecting others, having physical strength, and self-reliance (Addis & Mahalik, 2003; Connell, 2005). Roles which men have, for example within their occupation and relationships can therefore be lost or changed and men may face challenges in coping with this loss and adapting to the changing roles. Masculine identity is therefore an important consideration for neuropsychological therapy and rehabilitation particularly because part of the process of rehabilitation concerns helping individuals with their sense of self.

Some evidence suggests that adherence to masculine ideals can be negatively associated with rehabilitation outcomes in TBI (Meyers, 2012). Barriers to engaging in rehabilitation services may include that working with professionals is viewed as requiring help and therefore suggests that the individual lacks strength or self-sufficiency to be able to cope (MacQueen, Fisher and Williams 2018). Viewing the self as being reliant on others can lead to experiences of shame and the perception of the self as weak. This can mean that developing therapeutic relationships may conflict with ideals of independence (Good et al., 2006; Sullivan, 2011).

However, aspects of masculine identity may also promote wellbeing in the context of adjustment to TBI for men. For example, there is evidence which suggests that adherence to dominant masculine ideals such as higher success, power and competition are associated with the perception of fewer barriers to community functioning (Good et al., 2006). Similarly, Schopp et al. (2006) found that there was a positive effect on functional outcomes for men who adhered to ideals such as winning and seeking status and the authors suggest that therefore drawing on these values can promote positive outcomes after TBI.

It is important that gender identities are considered as part of rehabilitation and providing a gender-sensitive service can begin during initial discussions when men are referred to a service and should be considered throughout rehabilitation. In addition, given the higher prevalence of mental health problems in the TBI population (Seel et al., 2003) it seems particularly important to work with individuals in reducing the stigma of mental health problems after brain injury. Within the context of masculine identity, the application of positive psychology constructs may be particularly beneficial. Positive psychology has been applied within acquired brain injury (ABI) rehabilitation and these initial studies indicate that the application of positive psychotherapy may promote wellbeing following ABI (Andrewes, Walker, & O’Neill, 2014; Cullen et al., 2016). The concepts of growth, strength and resilience within positive psychotherapy may particularly encourage flexibility in identity which may facilitate adjustment for men.

The implications arising from the research in relation to issues around engagement and outcomes in neuropsychological therapy and rehabilitation are further considered within my chapter in the Palgrave Handbook of Male Psychology and Mental Health.

Dr. Ruth MacQueen completed the Doctorate in Clinical Psychology at the University of East Anglia in 2016. Her doctoral thesis employed a

qualitative methodology to research men’s experiences of masculine identity following traumatic brain injury. She has presented her research as a poster

publication at the Neurological Rehabilitation Specialist Interest Group of the World Federation for Rehabilitation conference and published in

Neuropsychological Rehabilitation. Since qualifying, Ruth has continued to work within neurorehabilitation in Bath, UK.

Dr. Paul Fisher is a Clinical Psychologist and Senior Clinical Lecturer with significant experience working clinically with people with neurological

impairments across a range of settings and as an academic and researcher. Paul has worked in the UK and Singapore. He has a long-standing interest

in issues of identity and identity change and adjustment which he uses within his clinical work and has been a focus for his research using qualitative

research methods. Paul currently works at the University of East Anglia in the Department of Clinical Psychology and in Norfolk and Suffolk NHS

Meyers, N. M. (2012). The effect of traditional masculine gender role adherence on community reintegration following traumatic brain injury in military veterans. (Doctoral Thesis) American University, Washington, D.C

It’s a familiar story. A young rebellious man seems out of control, always getting into conflict and looking destined for prison. Somehow he finds out about the local boxing club. Maybe it’s his last chance, or maybe it’s just a challenge he won’t refuse. But one thing leads to another and he suddenly finds that he has got something that is more important in his life than getting into trouble. Somehow or other, boxing has saved him from wasting his life.

If the NHS clinical psychology or forensic psychology services could replicate this kind of success story they would quickly recognise it as a breakthrough treatment programme. In fact some people outside boxing are starting to recognise the mental health benefits of this activity, and it just so happens that an old-school boxing club in Birmingham is leading the way. When I found out a few months ago that something called the Mind-Fit programme had won a mental health prize, I tracked down Paddy Benson of the Pat Benson Boxing Academy as quick as I could to find out more:

Barry: Congratulations Paddy on getting a prize for your wellbeing programme. What are your thoughts on your programme, and on the impact of boxing on men’s mental health?

Benson:It started after we had a guy who was from a substance abuse background. He used to train a lot, but sometimes he would go missing. We knew when he went missing he was on a relapse. One day we started chatting with him, and he opened up and said he really valued the structure and routine of the boxing training, which is why he kept coming back. That’s what he was really looking for and that kept him on the right track, away from drugs. We realised that we hadn’t given him any special treatment, but the boxing environment and routine had helped him deal with drugs. In fact of course training is a natural high, a release of endorphins.

Within about 30 mins radius there are lots of charities where we are in Birmingham, so we talked to them and put together a basic mental health package. We think that men’s mental health is a taboo subject at present, but one that will explode soon.

We evolved this programme due to feedback. We try to get the best out of everyone. Our strategy is inclusive – it’s not just for the top half-percent of boxers to win national titles. The programme is one hour per week doing bags and pads in a traditional boxing club, and participants like being coached in this real environment.

We have some specialist mentor staff, we have a social group – basically getting men to talk – and the feedback has been fantastic. We’ve had a national sporting award, and started getting funding. This is social prescribing. These guys are going to their GP but don’t necessarily need a clinical psychologist. For some people who have been using drugs or homeless, just eating fresh fruit is a new thing. The routine is the main thing.

We have worked with Nottingham Trent for a case study, but more with Brunel. Street Games provided free mental health first aid. Some of the participants get back on the straight and narrow, become mentors themselves, and even go on to university.

Barry: Are other things like martial arts just as good, or is boxing special?

Benson: Getting fit and building trust is key. Anyone will feel better. And staying away from drugs. Maybe boxing is more old school so there is a special sort of traditional aura. Our trainers have been around. This does help build trust. It’s hard to explain, but over time participants start to talk. They even start to trust themselves more when they feel more confident and healthy.

Barry: Do you think gaining meaning in life is important?

Benson: Yes, if you have been homeless or on drugs you know you are on the wrong path. When they meet us they mostly right away want to get their lives back on track. Finding an identity and purpose in life is a real achievement. They also learn to help others and give something back.

[Interview ends].

Some of the findings of my research in male psychology are things that are fairly unsurprising to most people who haven’t been steeped in the ideology of gender studies. However in these strange days when traditional masculinity is misunderstood even by psychologists in the US and UK, finding ways to help men’s mental health can sometimes be best done outside of mainstream mental health services. Important understandings about gender aren’t yet part of the psychology syllabus, for example, that when distressed, women often want to talk about their feelings whereas men would rather fix their problems. With men more likely than women to kill themselves, but less likely to seek help from a therapist, it’s my prediction that rediscovering how men have, for generations, been taking care of their mental health might benefit modern psychology. Activities like boxing might not appeal to everyone, but a pilot study by Brunel found it worked for the 24 participants on Benson’s Mind-Fit programme. Without a doubt the merit of this approach is worth further investigation.

About Paddy Benson

Paddy Benson trains in the Pat Benson Boxing Academy, a club based Birmingham’s Irish Quarter – produced the likes of champion Matthew Macklin and is currently training future world class boxers. The Academy was created to honour legendary trainer from Mayo in Ireland, Pat Benson, after he was crowned BBC Unsung Hero 2010. Pat and his grandson Paddy, a University business graduate who has also boxed for England Youth, work together in the family run club. Paddy will be giving a short presentation at the Male Psychology Conference at University College London in June.

About John Barry

Dr John Barry is a Chartered Psychologist and Associate Fellow of the British Psychological Society, Honorary Lecturer in Psychology at University College London, clinical hypnotherapist, and author of over 60 peer-reviewed publications on a variety of topics in psychology and medicine. John is a professional researcher and has taken an interest in improving the teaching of research methods and statistics. He has practiced clinical hypnosis

for several years and is a member of the British Association of Clinical and Academic Hypnosis. His Ph.D. was awarded by City University London, on the topic of the Psychological Aspects of Polycystic Ovary Syndrome. He is co-founder of the Male Psychology Network, and co-founder of the Male Psychology Section of the British Psychological Society. He is one of the authors of the new Palgrave Handbook of Male Psychology and Mental HealthDOI: 10.1007/978-3-030-04384-1

According to the NHS, attention deficit hyperactivity disorder (ADHD) is a behavioural disorder that includes symptoms such as inattentiveness, hyperactivity and impulsiveness. The ADHD Institute says that 50-65% of patients with ADHD in childhood will continue with their symptoms into adulthood.

The chapter in the Palgrave Handbook of Male Psychology and Mental Health focuses on the prevalence manifestation of ADHD in men. The neuro-developmental nature of ADHD means that it will occur from birth in men and contribute towards complexities and difficulties in men’s mental wellbeing.

Recognising the symptoms and difficulties early in life and forming a realistic approach to managing these through adapted cognitive behaviour therapy techniques and lifestyle management is the focus of this chapter. The chapter offers insights into the backdrop of ADHD from its early origins with the famous case of “Fidgety Phil,” through to more recent information from neuroscience.

Currently our understanding of ADHD helps us to identify the three main subtypes of ADHD in individuals. First there is the inattentive subtype with difficulties of concentration, focus and organization. Then there is the hyperactive/impulsive subtype with restlessness, fidgeting, disruptive behaviours and impulse management difficulties. Thirdly there is the combined type, where an individual struggles with all of the aforementioned symptoms. Identifying ADHD through more subtle traits when obvious hyperactivity/impulsivity is not present is a challenge in clinical work. Individuals who present with only inattention traits and moderate difficulties often remain in the revolving door of treatments and clinics, until such time as more clarity of traits becomes apparent.

Psychopharmacological interventions are focussed on managing the neurochemical and and brain activation issues. Medication helps in executive functions in individuals by improving focus, attention and overall activation.

Adapted cognitive behaviour therapy based on behavioural interventions – in particular organizational and activity scheduling, problem solving, working on sleep routines and implementation of graded steps – has been the key focus on treatment for ADHD.

Would the world be better off without the existence of ADHD symptoms and traits? Hardly. Strip away ADHD and we may take away our evolutionary pattern of neurodiversity. The hyperactivity and impulsivity when channeled in the right manner offers healthy risk taking, ability to perform high energy and intensity tasks and a mind that can think outside the box when a problem arises.

Hyperfocus aids individuals to attain higher performance and success when channeled into careers, passions, hobbies and inventions. For the deficits of the executive functions in the brain, sociability, emotional quotient and charm is aplenty. ADHD symptoms are part of the rich tapestry of human character and, in measure and in context, can be enriching for the individual and the world they are part of.

About the author

Bijal Chheda-Varma is a CPsychol Chartered Psychologist (BPS), Practitioner Psychologist (HCPC Reg.) and CBT Therapist Founder and Director, Foundation for Clinical Interventions, London. She is the founder and director of the Foundation for Clinical Interventions (FFCI) which specializes in the assessment, diagnosis and treatment/support for autism,Asperger’s syndrome, ADHD and other neurodevelopmental and neurocognitive conditions. Dr. Chheda-Varma’s niche is in offering intensive, but goal-oriented and time-limited treatment and therapy. She uses evidence-based treatment models and CBT is her predominant therapy style in both individual and group therapy. She sees a wide spectrum of clinical and complex psychological conditions but specializes in mood disorders, anxiety disorders, OCD and eating disorders. After beginning her career as a lead Psychologist within a rehabilitation unit for addictions, Dr. Chheda-Varma went on to be the lead clinician for the Nightingale Hospital’s CBT team from June 2013 until June 2014. Currently, she practises at the Nightingale Hospital, The Blue Door Practice alongside her own private clinic.

Dr Chheda-Varma is running a workshop on this topic at the Male Psychology Conference at UCL in June 2019. You can sign up for a place on the workshop here.